Question

1. which of the following statements by a patient receiving levothyroxine for hypothyroidism suggests the need for additional teaching?

i put an alarm on my phone to remind me to take this at the same time every day.
i crush the tablet in water because i have trouble swallowing the tablet whole.
i take this in the morning because it was keeping me awake when i took it at night.
i take this medication before breakfast with my daily multivitamin.

Explanation:

To determine the statement indicating a need for additional teaching, we analyze each option based on levothyroxine administration guidelines:

1. Option 1: Taking levothyroxine at the same time daily is correct (maintains consistent hormone levels), so no teaching needed here.
2. Option 2: Crushing levothyroxine tablets is generally acceptable if swallowing is difficult (as long as it’s not an extended - release formulation, and mixing with water for immediate consumption is fine), so this is not an error.
3. Option 3: Taking it in the morning (to avoid insomnia from nighttime dosing) is correct, so no teaching needed.
4. Option 4: Levothyroxine should not be taken with multivitamins (or other supplements/foods containing calcium, iron, etc.) because they can interfere with absorption. Taking it with a multivitamin shows a lack of understanding, indicating the need for additional teaching.

Answer:

I take this medication before breakfast with my daily multivitamin.